If you’re undergoing or planning to undergo gender transition, you may be prescribed hormone therapy. If you’re also thinking about preserving your fertility in order to have children in the future, you are likely to need to stop taking your hormone medication while undergoing fertility preservation treatments. Here we’ll explore why that may be necessary and provide you with a better understanding of how it could affect your mental health and how you can prepare yourself. 

What does hormone therapy do? 

Hormone therapy for gender transition causes changes to your physical appearance. During masculinising hormone therapy, you may be given testosterone to suppress your menstrual cycle, but it can also deepen your voice, and encourage muscle growth and the growth of facial hair. During feminising hormone therapy, you may be given oestrogen to suppress testosterone levels, which can reduce facial hair growth and encourage your breasts to grow.

Why might you need to stop hormone therapy for fertility treatment?

Oestrogen and testosterone therapies can change your physical appearance, but they can also have an impact on your fertility. 

  • Oestrogen suppresses testicular function and can have an impact on libido, erectile function and ejaculation. If you’re looking to preserve your sperm for future family purposes, you may need to consider stopping hormone therapy to regain testicular function and to have viable sperm to freeze.
  • Testosterone suppresses ovarian function and may impair ovulation. If you’re looking to preserve your eggs for future family purposes, you will most likely need to consider stopping hormone therapy for your ovaries to respond to the hormone stimulation needed for this treatment. 

What happens if you stop taking hormone medication?

For some people, fertility can be restored when they stop their hormone therapy, although it’s not a guarantee. If you need to pause your hormones for fertility treatment, it might lead to a reversal of the physical changes you’ve experienced with gender transition.  

For trans men this could mean:

  • the return of your periods
  • body fat redistribution
  • decrease in muscle mass

For trans women this could mean:

  • the return of testicular function
  • increased spontaneous erections
  • body fat redistribution 

Along with physical changes, you may experience hormonal changes such as mood swings. These changes may trigger gender dysphoria. This can be particularly upsetting as gender dysphoria is often something many people may have struggled with a lot before having access to hormone therapy. In order to get the best support possible when proceeding with fertility treatment, it’s important to be open with your care team – your GP, gender identity clinic, fertility specialists and counsellors. 

As it can be distressing to stop taking hormones because of the impact they can have on your mental health and daily life, you may choose not to proceed with fertility preservation. Instead, you could explore other options to grow your family, such as surrogacy or adoption. 

Additional information

Having children may not be on your mind right now, but it could be helpful to discuss the topic with other trans people who have been in your position. The Gender Identity Development Service can discuss fertility with you, and your family members should you wish. 

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